=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023931144
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUNRISE COMMUNITY HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2026
-----------------------------------------------------
Last Update Date | 08/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2930 11TH AVE
-----------------------------------------------------
City | EVANS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80620-1011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-350-4606
-----------------------------------------------------
Fax | 970-350-4692
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5311 W. 20TH STREET SUITE A
-----------------------------------------------------
City | GREELEY
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-702-7200
-----------------------------------------------------
Fax | 970-702-7700
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CREDENTIALING
-----------------------------------------------------
Name | LISA ASPROMONTE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 970-350-4602
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------